Nose and paranasal sinuses: silent sinus syndrome: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose and paranasal sinuses: silent sinus syndrome

Sample item

A 35-year-old notices his right eye sinking, with a deeper upper lid crease, without pain or nasal symptoms. CT shows a small opacified right maxillary sinus with the orbital floor bowed inwards and obstruction of the ostium. What is the diagnosis?

AMaxillary mucoceleBOld orbital blow-out fractureCFibrous dysplasia of the maxillaDSilent sinus syndrome

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Silent sinus syndrome

In silent sinus syndrome chronic ostial obstruction causes negative pressure and hypoventilation, so the maxillary sinus collapses, the orbital floor sinks and the eye shows enophthalmos and hypoglobus. Treatment is endoscopic opening of the ostium, with orbital floor reconstruction if needed. A mucocele expands the sinus and pushes the orbit upwards.

Option by option

A. Maxillary mucocele
A mucocele expands the sinus and displaces the eye outwards.
B. Old orbital blow-out fracture
An old blow-out fracture has a history of trauma and a bony defect.
C. Fibrous dysplasia of the maxilla
Fibrous dysplasia enlarges the bone with ground-glass change rather than collapsing the sinus.
D. Silent sinus syndrome (correct)
Correct. A shrunken sinus with an inward-bowed floor and a sunken eye define the syndrome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Silent sinus syndrome. In silent sinus syndrome chronic ostial obstruction causes negative pressure and hypoventilation, so the maxillary sinus collapses, the orbital floor sinks and the eye shows enophthalmos and hypoglobus.

Why is "Maxillary mucocele" not the answer?

A mucocele expands the sinus and displaces the eye outwards.

Why is "Old orbital blow-out fracture" not the answer?

An old blow-out fracture has a history of trauma and a bony defect.

Why is "Fibrous dysplasia of the maxilla" not the answer?

Fibrous dysplasia enlarges the bone with ground-glass change rather than collapsing the sinus.

What concept does this question test?

It tests Nose and paranasal sinuses: silent sinus syndrome in ENT. Treatment is endoscopic opening of the ostium, with orbital floor reconstruction if needed. A mucocele expands the sinus and pushes the orbit upwards.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose and paranasal sinuses: silent sinus syndrome?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.